Impacting device and method

ABSTRACT

An impacting device including a head having a longitudinal axis, a lateral surface and a base surface. The impacting device also includes a recess positioned in the head having a first channel and a second channel, the first and second channels being operably connected to each other. The first and second channels are at an angle with respect to each other when viewed in a plane parallel to the longitudinal axis.

CROSS REFERENCE TO RELATED APPLICATION

The present application is a continuation of U.S. patent applicationSer. No. 11/447,385 filed on Jun. 5, 2006, now U.S. Pat. No. 8,080,015which is a continuation of International Application No.PCT/IB2004/002601 filed Aug. 11, 2004, the entire content of which isexpressly incorporated herein by reference thereto.

FIELD OF THE INVENTION

A device and method for impacting surgical devices and, in particular,an impacting device for inserting, positioning and/or removing animplant and/or performing other impacting applications in surgery.

BACKGROUND OF THE INVENTION

In general, surgical mallets are known which are guided on devices forthe insertion and/or extraction of implants, in particularintramedullary nails. U.S. Pat. No. 5,476,467 and WO 80/00534 disclose amallet having a cylindrical shape and a centered bore which follows thelongitudinal axis and by means of which the mallet slides over theinsertion or extraction device. Guidance of these mallets may bedifficult since the surgeon can only exert force on the mallet bygripping the cylinder on its lateral surface by hand. Moreover, thesemallets can be used only with a particular insertion device.

Improved surgical mallets, such as those disclosed in U.S. Pat. No.5,913,860 and in DE 19860569, disclose mallets which have a cylindricalmallet head and a mallet shaft for facilitating guidance of the surgicalmallet. The surgical mallet of U.S. Pat. No. 5,913,860 not only has acylindrical bore but also has a recess so that the surgical mallet canbe introduced after assembly of the insertion device. Thus, thissurgical mallet is universally applicable and, consequently, can be usedas a mallet for directly driving, for example, nails into tissue.However, the guidance of the mallet on the insertion device may becomplicated. Due to the slotted design, the mallet head may not besecurely held on the implantation device (e.g., a guide rod) and, uponmoving the mallet, the mallet may slip off the guide rod. As a result,the precision of a procedure may be impaired and the danger of injurymay increase for the surgeon and others.

Furthermore, in a mallet embodiment having a slotted design, the slotintersects the base or impact surface of the cylindrical mallet head(i.e., the surface which is used for striking/impacting). Use of themallet is complicated since it is necessary to ensure that the nailhead, the nail end or other instruments which are used for insertion arestruck with the intact surface and not in the area where a slotintersects the base surface. Therefore, the lateral or side surface ofmallets designed in this manner (i.e., with a slot intersecting thebase) are usually used as the impacting surface to impact an instrument.However, when hammering with the side surface of the mallet, the mallethead tends to be springy upon impact.

U.S. Pat. No. 6,592,590 discloses a surgical mallet which has a guidechannel for a guide rod. The guide channel is designed so that themallet head is prevented from being removed from the guide rod in thelateral direction. The impact surface of the mallet head is interrupted,so that the mallet can be reliably used only in combination with a guiderod. The mallet head tends to slip downwards from the guide rod onslight canting of the head. This may happen quickly since movement ofthe mallet on the guide rod is contradictory to natural human movementwhen impacting an object vertically. It is more advantageous to move themallet in a gentle arc. However, it is the arc movement which leads tothe guide rod slipping out of the slot of the mallet head.

It is desirable to have an impacting device, which provides the devicefor insertion and/or extraction of the implant (e.g., a guide rod), withguidance. Moreover it is desirable to have a impacting device, which maybe attached to a guide rod after attaching the guide rod to an implant,is reliable for use in striking an implant and can be used universallywith different types of guide rods and/or implants.

SUMMARY OF THE INVENTION

The impacting device may have a head having a longitudinal axis, alateral surface and at least one base surface; and a recess positionedin the head which may have a first channel and a second channel. A shaftmay be operably associated with the head and a handle may be operablyassociated with the shaft. The handle may have at least one flat side.

The first and second channels may be separated a distance from eachother and operably connected to each other. The first and secondchannels may intersect the lateral surface. The first channel may be aninsertion channel for receiving a guide means and the second channel maybe a locking chamber for attaching the guide means to the head. Thelocking chamber may be sized and configured so that the head may berotatable about the longitudinal axis on the guide means. At least onespherical pressure pin may be positioned in the locking chamber of thehead to keep the guide means in the locking chamber.

Moreover, the head may have a third channel which may connect the firstand second channels. The third channel may be an axial channel extendingparallel to the longitudinal axis. The first channel may be in a firstplane, the second channel may be in a second plane and the third channelmay be in a third plane. The first and second planes may be parallel toeach other and the third plane may be perpendicular to the first andsecond planes. The first and second channels may have an angletherebetween, wherein the angle may be between about 20° and about 150°.

In an alternative embodiment, the impacting device may have a headhaving a longitudinal axis, a lateral surface and at least one basesurface; and a recess positioned in the head which may have a firstchannel and a second channel. The first and second channels may beoperably connected to each other and may be at an angle with respect toeach other. The first channel may be an insertion channel and the secondchannel may be a locking chamber for receiving a guide means. Thelocking chamber may have at least one protrusion for holding the guidemeans in the locking chamber. The locking chamber may be sized andconfigured so that the head may be rotatable on the guide means aboutthe longitudinal axis. The locking chamber may have a first slopingsurface and a second sloping surface. The first and second slopingsurfaces may form a V-shape.

A method of inserting or removing a device/implant from tissue maycomprise providing an impacting device comprising a head having alongitudinal axis, a lateral surface and at least one base surface; anda recess positioned in the head having a first channel, a second channeland a third channel connecting the first and second channel. The methodmay further comprise inserting the guide means into the first channel ina direction perpendicular to the longitudinal axis; moving the guidemeans through the third channel along the longitudinal axis; insertingthe guide means into the second channel; and rotating the guide meanswithin the second channel so that the head may be moveable along theguide means. The impacting device may designed to allow a surgeon tomove his/her hand and/or a handle of the device in an arc-like manner asthe head moves along the guide means.

Alternatively, the method of inserting or removing a device from tissuemay include providing an impacting device comprising a head having alongitudinal axis, a lateral surface and at least one base surface; anda recess positioned in the head which may have a first channel and asecond channel, the first and second channels may be operably connectedto each other, wherein the first and second channels may be at an anglewith respect to each other. The method may further include inserting aguide into the first channel, rotating the guide means to position theguide means from the first channel into the second channel, and rotatingthe head about the longitudinal axis as the head is moved along theguide means.

The design of the impacting device may allow the impacting device to beused as a normal mallet for striking. Consequently, a surgeon may usethe impacting device with a guide means to insert/extract an implant aswell as freely striking a tool or tissue (i.e., without guidance).

Owing to the design of the recess in the head of the impacting device,various improvements may achieved over previous devices. Although thehead of the impacting device may be inserted after assembly of thedevice for insertion and/or extraction, a type of locking of the head bymeans of the device may be achieved. By providing separate regions, suchas insertion channel, axial channel and locking chamber, the insertionof the guide rod may so complex that it may be possible to remove thehead from the device only through a bayonet connection-like movement inthe opposite direction of insertion. The head remains fixed by thedevice during striking because the movement necessary to remove the headfrom the recess is not carried out during striking. Since injuries anddamage to implants and instruments often occur as a result of impreciseimpacts, the reliable guidance of the head on the guide means may permitprecise impacts, which may have a noticeable positive effect both whendriving in and when driving out implants. Furthermore, as a result ofthe design of the recess in the head, the full impact force may bemaintained.

In one embodiment, the recess may be provided only in the lateralsurface so that the base surfaces may remain intact. Consequently, theentire base surfaces of the impacting device may be maintained as impactsurfaces. However, even if the recess is positioned so that the recesswas positioned through the base surfaces, the impact force on thelateral surfaces may be substantially maintained because springinessduring striking may be substantially prevented. Thereduction/elimination of springiness may be due to the bayonetconnection-like arrangement of insertion channel, axial channel andlocking chamber of the recess. Furthermore, if the center of gravity ofthe head is located in the extrapolated axis of the shaft or in the axisof a guide rod, the danger of canting during sliding on the guide rodmay also be minimized.

BRIEF DESCRIPTION OF THE DRAWINGS

The impacting device can be better understood by reference to thefollowing drawings, wherein like reference numerals represent likeelements. The drawings are merely exemplary to illustrate certainfeatures that may be used singularly or in combination with otherfeatures and the impacting device should not be limited to theembodiments shown.

FIG. 1 is a perspective view of an exemplary embodiment of an impactingdevice illustrating various orientations of a guide means positionedthrough the device;

FIGS. 2A and 2B are schematic diagrams of the movement of a guide meansthrough a recess of the impacting device;

FIGS. 3A, 3B and 3C are different views of an exemplary embodiment ofthe impacting device of FIG. 1;

FIGS. 4A, 4B, 4C and 4D are different views of an exemplary embodimentof the head of the impacting device of FIGS. 3A-3C;

FIG. 5 is a perspective view of the impacting device of FIG. 1positioned on a guide means;

FIG. 6 is an alternative view of the impacting device of FIG. 5;

FIGS. 7A and 7B are different views of an alternative exemplaryembodiment of an impacting device;

FIGS. 8A, 8B and 8C are different views of the head of the impactingdevice of FIGS. 7A and 7B; and

FIG. 9A-9G are different views of the impacting device of FIGS. 7A and7B in use.

DETAILED DESCRIPTION

The impacting device may be used for insertion and/or extraction ofimplants, for example, intramedullary rods/nails and Kirschner wires.The impacting device may also be used for impacting otherinstrumentation positioned in the body. The impacting device may have ahead and at least one recess for receiving a guide means such as a guiderod. In some embodiment, the impacting device may have a shaft formoving the head. It should, however, be understood that those ofordinary skill in the art will recognize many modifications andsubstitutions which may be made to various elements of the impactingdevice.

FIG. 1 illustrates an impacting device 1 a attached to a guide meanssuch as guide rod 17, an extraction rod or a sliding rod. The impactingdevice 1 a may have a head 2 a and a shaft 3 a. The head may be anshape. In a preferred embodiment, the head 2 a may be generallycylindrical in shape.

The head 2 a may have a lateral surface 4 a, base surface(s) 5 a and atleast one recess 6 a. The recess 6 a may be slot-like. The recess 6 amay have guide regions such as an insertion channel 7 a into which aguide means may be initially inserted into the head 2 a and a lockingchamber 9 a into which the guide means may be received so that the head2 a may be guided for impacting/striking. The locking chamber 9 a may beoriented radially and/or may be an elongated hole. In one embodiment,the insertion channel 7 a and locking chamber 9 a may not directlyintersect (e.g., the planes of the insertion channel 7 a and lockingchamber 9 a may be approximately parallel to each other). In such anembodiment, the insertion channel 7 a and locking chamber 9 a may beconnected to each other by another guide region such as axial channel 8a. As shown in FIGS. 3A and 3B, the plane of the insertion channel 7 aand/or the locking chamber 9 a may be perpendicular to the plane of theaxial channel 8 a.

The dimension of the recess 6 a may depend on the device to be insertedtherein. For example, the dimension of the recess 6 a may be adapted toreceive the guide rod 17. The insertion channel 7 a and the lockingchamber 9 a may be positioned at an angle α (FIG. 4D) relative to eachother. The angle α may be, for example, between about 10° and about160°, more preferably, between about 20° and about 150°, even morepreferably, between about 20° and about 70° and, most preferably,between about 30° and about 40°. In another embodiment, a preferredangle between the insertion channel 7 a and the locking chamber 9 a maybe about 80°. The angle may be chosen so that, once inserted into thelocking chamber 9 a, the guide rod 17 does not move out of the lockingchamber 9 a and/or axial channel 8 a during the sliding/impactingoperation. Moreover, the insertion chamber 7 a may be arranged at anangle to the axial channel 8 a. For example, the insertion channel 7 amay be arranged at an angle to the axial channel 8 a of between about20° and about 160° and, more preferably, between about 30° and about150°. In one embodiment, a preferred angle between the insertion channel7 a and the axial channel 8 a may be about 80°. Furthermore, theinsertion channel 7 a may be arranged at an angle to the longitudinalaxis 11 of the head 2 a of between about 20° and about 70° and, morepreferably, between about 40° and about 50°.

The axial channel 8 a may be positioned parallel to the longitudinalaxis 11. In one embodiment, the axial channel 8 a may be in a planewhich may extend along the longitudinal axis 11. In an alternativeembodiment, the recess 6 a may be formed in a base surface 5 a as wellas the lateral surface 4 a. In such an embodiment, the axial channel 8 amay be approximately perpendicular to the longitudinal axis 11 of thehead 2 a.

The guide regions (i.e., insertion channel 7 a, axial channel 8 a andlocking chamber 9 a) may occupy a space inside the head 2 a which maynot coincide with another space or region. The recess 6 a may bedesigned so that the guide means or device for insertion and/orextraction may be inserted with a bayonet-like connection. Guide meansor device for insertion and/or extraction of implants may pass throughthe entire extent of one region before reaching the next, adjacentregion. For example, the guide means may necessarily pass entirelythrough the insertion channel 7 a before entering the axial channel 8 aand the guide means may necessarily pass entirely through the axialchannel 8 a before entering the locking chamber 9 a. In this way, theguide means may experience improved guidance. The recess 6 a may bedesigned so that, in order to insert a guide means such as guide rod 17into the head 2 a, at least one predominantly horizontal, at least onepredominantly vertical insertion movement and a rotational movement maybe required. Such a technique is in contrast to existing slotted malletswhich may require an individual horizontal or vertical movement, or ahorizontal and a tilting movement.

The guide means is not only guided in the recess 6 a, but may be lockedin the locking chamber 9 a so that the guide means may not detach fromthe head 2 a during impacting or the insertion/extraction process.Moreover, the locking chamber 9 a may have additional locking elementssuch as, for example, spherical pressure pins for holding a guide meansin the locking chamber 9 a. The arrangement of the components/guideregions of the recess 6 a may prevent the guide means from becomingdisengage from the head 2 a during hammering. Even if the impactingdevice 1 a were to be driven in a slightly canted manner, the head 2 adoes not disengage (slip off) the guide means or guide rod 17. Moreover,the striking direction may be more comfortable for the surgeon since acertain play may remain in the locking chamber 9 a. In particular, itmay be possible for a surgeon to execute a gentle arc with his/her handand/or a handle of the device during striking while, at the same time,reliably guiding the guide rod 17. For example, the head 2 a may rotateabout its longitudinal axis 11 during the striking movement. It shouldbe noted that the impact direction may be substantially perpendicular tothe longitudinal axis 11 of the head 2 a.

A guide means such as guide rod 17 may be inserted into the recess 6 aof the impacting device 1 a. The guide rod 17 may be moved from a firstposition immediately upon insertion into the recess 6 a (shown by rod17′ in dashed lines) to a second position (shown by rod 17) (i.e., theposition in which the impacting device 1 a may be guided along the guiderod 17). The manner of inserting a guide means, such as guide rod 17,into the recess 6 a is shown in FIGS. 2A and 2B. In particular, FIGS. 2Aand 2B illustrate the movement of a guide rod 17 into the recess 6 a.All designations of the direction of movement in the description ofFIGS. 2A and 2B relate to the longitudinal axis 11 of the head 2 a. Uponinsertion of the guide rod 17 into the insertion channel 7 a, the guiderod 17 may be moved radially towards the longitudinal axis 11—radialmovement 14. Thereafter, the guide rod 17 may be guided (translated)along or parallel to the longitudinal axis 11 of the head 2 a (i.e., theguide rod 17 may be moved axially)—axial movement 15. For example, theguide rod 17 may be moved down along the axis 11 or axial channel 8 a.After reaching the plane of the locking chamber 9 a, the guide rod 17may be rotated—rotational movement 16—so that the rod 17 may be lockedin the head 2 a of the impacting device 1 a. As shown in FIG. 1, theguide rod 17 may be rotated counterclockwise within the locking chamber9 a about the longitudinal axis 11. It should be noted that in otherembodiments, the recess 6 a may be configured so that the guide rod 17may be rotated clockwise within the locking chamber 9 a to fix the rod17 within the head 2 a.

In another configuration of the recess 6 a, the rod 17 may be insertedinto the insertion channel 7 a and rotated—rotational movement 16—forexample, about the longitudinal axis 11 or about a line parallel to theaxis 11. The rotation may be clockwise or counterclockwise depending onthe configuration of the recess 6 a. Thereafter, axial movement 15(e.g., along the axis 11 or along a line parallel to the axis 11) may beexecuted, followed by radial movement 14 (e.g., toward the axis 11). Inanother embodiment, the axial channel 8 a may be sized and configured sothat a guide means may rotate and move axially within the axial channel8 a. In such an embodiment, the guide means may be moved radially withinthe insertion channel 7 a and the locking chamber 9 a. Those skilled inthe art will appreciate that the recess 6 a may be configured in anyother way so long as the recess 6 a has a plurality of separate regionsby which a guide means may be locked and guided after insertion into therecess 6 a.

Since the recess 6 a is provided in the lateral surface 4 a of the head2 a, the base surfaces 5 a may remain intact, uninterrupted, solid orcohesive (i.e., there are no interruptions or slots in the surfaces 5a). Consequently, in an embodiment where no guide means is used the basesurfaces 5 a may provide a regular impact surface.

The shaft 3 a may be attached to the head 2 a to provide an operatorwith a surface to grip so that the operator may move the head 2 a alonga guide means and/or impact the head 2 a with another device or tissue.The shaft 3 a may be integral with or attachable to the head 2 a.Moreover, the shaft 3 a may be fixed and/or rotatable relative to thehead 2 a. Those skilled in the art will appreciate that a head 2 a maybe formed without a shaft 3 a.

The shaft 3 a may be any shape or size so long as the surgeon may graspthe shaft 3 a and use the shaft 3 a to move the head 2 a. For example,the shaft may be cylindrical or polygonal. In some embodiment, the shaft3 a and/or a handle (not shown) attached to the shaft 3 a may beergonomically designed so that the shaft 3 a and/or handle may fitcomfortable into an operator's hands. For example, the shaft 2 a mayhave an anatomically shaped handle with, for example, two approximatelyparallel gripping surfaces (not shown) which are each in a plane normalto the base surfaces 5 b.

An alternative impacting device 1 b is illustrated in FIGS. 3A-3C and4A-4D. Similar to the impacting device 1 a of FIG. 1, the impactingdevice 1 b may have a head 2 b and a shaft 3 b which may be welded toeach other. Alternatively, the shaft 3 b may be connected to the head 2b at a pivot so that the head 2 b and shaft 3 b may rotate relative toeach other. The head 2 b and the shaft 3 b made be made of metal whichmay be suitable for medical purposes such as, for example, stainlesssteel, titanium or chromium-nickel (e.g., 5CrNiCuNb16-4).

A handle 10 may be provided on the shaft 3 b and may be connected to theshaft 3 by, for example, pins. The handle 10 may have at least oneflattened side so as to provide an enhanced gripping surface for asurgeon and to ensure that the impacting device 1 b rests in the correctposition in the hand. The handle 10 may be formed from a material whichmay have a good grip but which may be readily sterilizable. For example,the handle 10 may be made of plastic, ceramic, wood, metal or acomposite material (i.e., two or more materials).

FIGS. 4A-4D illustrate different views of the head 2 b. The head 2 b mayhave a substantially cylindrical shape and rounded edges 18 may beprovided between the lateral surface 4 b and the base surfaces 5 b. Sucha configuration may result in a difference in design from FIG. 1. Thoseskilled in the art will appreciate that the head 2 b may also benon-cylindrical in shape. The lateral surface 4 b may be barrel shapedor may comprise cylindrical or flat impact surfaces and the basesurfaces 5 b may be barrel-shaped.

The head 2 b may have at least one recess 6 b for receiving a guidemeans (e.g., a guide rod 17, extraction rod or sliding rod) forinsertion and/or extractions of implants. The recess 6 b may alsoinclude an insertion channel 7 b, a locking chamber 9 b and an axialchannel 8 b positioned between the insertion channel 7 b and the lockingchamber 9 b. The insertion channel 7 b and the locking chamber 9 b maybe positioned at an angle relative to one another. FIG. 4D shows thelongitudinal axis 19 of a guide rod (not shown) in the insertion channel7 b and the longitudinal axis 20 of the guide rod (not shown) in thelocking chamber 9 b.

The shaft 3 b may be arranged off-center to the head 2 b so that thecenter of gravity of the head 2 b may pass through an extrapolation ofthe shaft axis 12. Because of the recess 6 b, one region of the head 2 bmay be lighter than the other region. For example, as shown in FIGS. 4Aand 4B, the recess 6 b may be in the upper region of the head 2 b and,therefore, may be lighter (i.e., weigh less) than the lower region,which may be substantially solid. Consequently, the attachment 13 of theshaft 3 b may be displaced in the direction towards the lower region ofthe head 2 b as shown in FIGS. 4B and 4C. The locking chamber 9 b andattachment 13 of the shaft 3 may be approximately in the same plane. Inthis way, guidance of the device to the impacting surface by a guidemeans may be facilitated. Moreover, since the recess 6 b and theinsertion channel 7 b may be positioned off-center in the head 2 b,there may be less risk of vibration when the upper base surfaces 5 b isused for striking.

FIGS. 5 and 6 illustrate the impacting device 1 c with a head 2 c, ashaft 3 c and a guide rod 17 positioned within the locking chamber 9 c.With the guide rod 17 in the locking chamber 9 c, the head 2 c of theimpacting device 1 c may be moved along the guide rod 17 to extract orinsert an implant. The head 2 c may have an insertion channel 7 c, anaxial channel 8 c and a locking chamber 9 c. Three regions may be formedin the head 2 c—a middle region which may have the insertion channel 7c, the axial channel 8 c and the locking chamber 9 c as well as endregions on either side of the middle region. The end regions may have nopassages therethrough (i.e., the end regions may be solid). Inparticular, since the recess 6 c may be formed in the lateral surface 4c, the base surfaces 5 c and 5 d may be solid impact surfaces which maybe free of passages.

The impacting device 1 a, 1 b and 1 c may be used in a conventionalmanner to directly or indirectly impact an instrument to insert orremove the implant from tissue or to perform other impacting/hammeringapplications. When a procedure does not require use of guide means, thebase surface 5 a, 5 b, 5 c, 5 d may be used as impacting surfaces. Inother procedures where a guide means may be used, the head 2 a, 2 b, 2 cmay be rotated approximate 90° about the axis of the shaft 3 a, 3 b, 3 c(e.g., axis 12) so that the head 2 a, 2 b, 2 c may be positioned on aguide means and the lateral surface 4 a, 4 b, 4 c may be used as theimpacting surface.

The guide rod 17 may be positioned into the recess 6 a, 6 b, 6 c throughthe insertion channel 7 a, 7 b, 7 c by tilting the impacting device 1 a,1 b, 1 c. Thereafter, the guide rod 17 may be moved in the axial channel8 a, 8 b, 8 c parallel and/or along the longitudinal axis of the head 2a, 2 b, 2 c (e.g., along the longitudinal axis 11) until the guide rod17 is positioned in the locking chamber 9 a, 9 b, 9 c. Once the head 2a, 2 b, 2 c is in the locking chamber 9 a, 9 b, 9 c, the head 2 a, 2 b,2 c may be capable of rotating around the rod 17 (e.g., about axis 11).The head 2 a, 2 b, 2 c may be rotated an angle θ (FIG. 4D), for example,between about +60° and about −60° and, more preferably, between about+40° and about −40°. Alternatively, locking chamber 9 a, 9 b, 9 c may beformed asymmetrically such that the rod 17 may rotate an angle, forexample, between about +40° and about −50°. Such asymmetry may beimprove the locking of the guide rod 17 in the locking chamber 9 a, 9 b,9 c.

In an embodiment where the insertion channel 7 a, 7 b, 7 c and lockingchamber 9 a, 9 b, 9 c may be substantially parallel to each other, theinsertion channel 7 a, 7 b, 7 c and locking chamber 9 a, 9 b, 9 c may bespaced apart by a distance S (FIG. 4A), preferably about 10 mm apart.The distance between the insertion channel 7 a, 7 b, 7 c and lockingchamber 9 a, 9 b, 9 c may be determined by the material used to form thehead 2 a, 2 b, 2 c. The distance may be chosen so that, depending on thematerial use, there may be sufficient dimension between the insertionchannel 7 a, 7 b, 7 c and locking chamber 9 a, 9 b, 9 c. In this way,the head 2 a, 2 b, 2 c may be sufficiently stable and/or strong. Such aconstruction may minimize bending of the head 2 a, 2 b, 2 c duringimpact and/or reduce the likelihood of the head 2 a, 2 b, 2 c breakingafter repeated use.

The attachment of the shaft 3 a, 3 b, 3 c (e.g., attachment 13 of shaft3 b) and the insertion channel 7 a, 7 b, 7 c may be positionedapproximately the same distance from the edge of the head 2 a, 2 b, 2 c.The axial channel 8 a, 8 b, 8 c may connect the insertion channel 7 a, 7b, 7 c and the locking chamber 9 a, 9 b, 9 c, and may have asize/dimension D (FIG. 4D), for example, of about 10.5 mm. Moreover, theedges of the insertion channel 7 a, 7 b, 7 c, axial channel 8 a, 8 b, 8c and/or the locking chamber 9 a, 9 b, 9 c may be rounded such that, asshown in FIG. 4A, the edges E may have a radius “r” of curvature ofabout 5 mm.

FIGS. 7A-8C illustrate an alternative impacting device 1 d. Theimpacting device 1 d may have a head 2 d, a shaft 3 d, a handle 10 doperably associated with the shaft 3 d and a longitudinal axis 11 d. Thehandle 10 d may have one or more flattened sides. A recess 6 d may bepositioned through the lateral surface 4 d and may not extendinto/through the base surfaces 5 d. Similar to previous impacting device1 a, 1 b, 1 c, one or both base surfaces 5 a, 5 b, 5 c, 5 d of theimpacting device 1 d may be uninterrupted, solid, intact or cohesive(i.e., the base surfaces 5 a, 5 b, 5 c, 5 d may not have slots or otherinterruptions therein).

The impacting device 1 d may have a recess 6 d, which may have aninsertion channel 7 d and a locking chamber 9 d. The locking chamber 9 dmay be horizontal and/or approximately perpendicular to the longitudinalaxis 11 d of the head 2 d. The locking chamber 9 d may be an elongatedpassageway or slot. The guide rod 17 d may be positioned in and movewithin this passageway or slot 9 d. As shown in FIG. 8A, the insertionchannel 7 d may be at an angle α with respect to the locking chamber 9d. Specifically, the angle α between the longitudinal axis 23 of theinsertion channel 7 d and the longitudinal axis 24 of the lockingchamber 9 d may be between about 20° and about 70° and, more preferably,between about 30° and about 50°. As shown in FIGS. 7A-8C, the angle αmay be about 50°. The insertion channel 7 d may be arranged obliquely onthe head 2 d relative to the longitudinal axis 11 d and may be formed topermit the insertion of the guide rod 17 d therethrough. There may be anangle β between longitudinal axis 11 d of the head 2 d and thelongitudinal axis 23 of the insertion channel 7 d which may be betweenabout 20° and about 70° and, more preferably, between about 40° andabout 50°. In one embodiment, the angle β may be about 40°.

FIGS. 9A-9G illustrates the mode of operation of the head 2 d. In orderto insert the head 2 d onto the guide rod 17 d, as shown in FIG. 9A, thehead 2 d may be mounted obliquely on the guide rod 17 d so that theguide rod 17 d may be introduced into the insertion channel 7 d. Thehead 2 d may then be rotated to the position shown in FIGS. 9B and 9C.Thereafter, as shown in FIGS. 9D and 9E, the head 2 d may be pushed intolocking chamber 9 d until the guide rod 17 d comes to rest in a centralposition. In this state, the head 2 d may be positioned onto the guiderod 17 d and a surgeon may move the head 2 d along the guide rod 17 d(e.g., back and forth movement), for example, to insert or extract animplant.

At the lateral surface 4 d, the locking chamber 9 d may be bounded by atleast one projection 21. In the embodiment shown in FIGS. 7A-8C, thelocking chamber 9 d may be bound by two projections 21. Theseprojections 21 may be staggered relative to one another and oneprojection 21 may be located on each side of the insertion channel 7 d.The guide rod 17 d may be locked in the locking chamber 9 d by theprojections 21 (i.e., the projections 21 may prevent the guide rod 17 dfrom separating from the head 2 d). The projections may bound thelocking chamber 9 d towards the outside. Because of the design of therecess 6 d and the orientation of the insertion channel 7 d relative tothe locking chamber 9 d, the projections 21 may not be an obstacle wheninserting the guide rod 17 d.

The latitude of movement, which the surgeon has when using the impactingdevice 1 d to insert or extract implants (e.g., an intramedullary nail),is shown in FIGS. 9F and 9G. The head 2 d may be moved over the guiderod 17 d through an angle 22 of about 80° about the center of the head 2d. Consequently, the surgeon may move his/her hand and/or a handle ofthe impacting device 1 d in an arc-like movement during insertion orextraction. The arc-like movement resembles natural striking movement.As shown in FIGS. 9F and 9G, the locking chamber 9 d may be obliquelyformed so that the guide rod 17 d may be rotated about the center of thehead 2 d. The locking chamber 9 d may be radially oriented and may havean outwardly or radially sloping surfaces 9 d″. For example, theradially sloping surfaces 9 d″ may have a highest point HP at about thecenter of the locking chamber 9 d and may slope down in the direction ofthe shaft 3 d such that the sloping surfaces 9 d″ may form a generallyV-shaped surface. The rod 17 d may sit atop the highest point HP asshown in FIGS. 9D and 9E. The head 2 d may be rotated so that the rod 17d moves along the slopping surfaces 9 d″.

The head 2 a, 2 b, 2 c, 2 d may allow the surgeon considerable latitudein the actuation of the device 1 a, 1 b, 1 c, 1 d for insertion and/orextraction of an implant and may provide guidance along a guide means.The configuration of the head 2 a, 2 b, 2 c, 2 d may also prevent thehead 2 a, 2 b, 2 c, 2 d from slipping off the guide means which may beused for insertion and/or extraction of an implant. Moreover, the designof the device 1 a, 1 b, 1 c, 1 d may allow the device 1 a, 1 b, 1 c, 1 dto be used similar to a conventional mallet, so that device 1 a, 1 b, 1c, 1 d may be universally applicable.

In use, the impacting device may be used to impact an instrument such asan intramedullary rod or nail or a component attached thereto.Alternative, the impacting device may be used for otherimpacting/hammering applications. The impacting device may be used witha guide means which may be attached to, for example, an intramedullaryrod or nail to guide movement of the impacting device. Those skilled inthe art will appreciate that a guide means may be unnecessary and asurgeon may freely move the impacting device to insert/hammer an implantinto tissue. The lateral surface and/or the base surfaces of theimpacting device may provide an impacting surface which may be used forhammering an implant.

While the foregoing description and drawings represent the preferredembodiments of the impacting device, it will be understood that variousadditions, modifications and substitutions may be made therein withoutdeparting from the spirit and scope of the impacting device as definedin the accompanying claims. In particular, it will be clear to thoseskilled in the art that the impacting device may be embodied in otherspecific forms, structures, arrangements, proportions, and with otherelements, materials, and components, without departing from the spiritor essential characteristics thereof. One skilled in the art willappreciate that the system may be used with many modifications ofstructure, arrangement, proportions, materials, and components andotherwise, used in the practice of the system, which are particularlyadapted to specific environments and operative requirements withoutdeparting from the principles of the impacting device. The presentlydisclosed embodiments are therefore to be considered in all respects asillustrative and not restrictive, the scope of the system beingindicated by the appended claims, and not limited to the foregoingdescription.

What is claimed is:
 1. An impacting device comprising: an elongatedshaft extending along a first longitudinal axis; an impacting headconfigured to be removably attached to the shaft and extending along asecond longitudinal axis angled relative to the first longitudinal axisand having a lateral surface and a base surface formed to impact a boneimplant when said impacting device is attached to the shaft; and arecess positioned in the head having a first channel and a secondchannel, the first and second channels being connected to each other,wherein the first and second channels are at an angle with respect toeach other when viewed in a plane parallel to the second longitudinalaxis and wherein the first and second channels do not intersect the basesurface.
 2. The impacting device of claim 1 wherein the first channel isan insertion channel and the second channel is a locking chamber forreceiving a guide means, the locking chamber having at least oneprojection for holding the guide means in the locking chamber.
 3. Theimpacting device of claim 2, wherein the locking chamber is sized andconfigured so that the head is rotatable on the guide means about thesecond longitudinal axis.
 4. The impacting device of claim 3, whereinthe locking chamber has a first sloping surface and a second slopingsurface.
 5. The impacting device of claim 4, wherein the first andsecond sloping surfaces form a V-shape.
 6. The impacting device of claim1, wherein the first and second channels intersect the lateral surfacebut not the base surface.
 7. The impacting device of claim 1, whereinthe angle is between about 20° and about 70°.
 8. The impacting device ofclaim 1, wherein the second longitudinal axis and the first channelcreate a further angle between about 20° and 70° when viewed in theplane.
 9. The impacting device of claim 2, wherein a first one of theprojections is disposed at a first end of the first channel and a secondone of the projections is disposed at a second end of the first channel.10. The impacting device of claim 9, wherein the first and second onesof the projections bound the second channel towards an exterior of thehead.
 11. The impacting device of claim 1, wherein the head issubstantially cylindrical.
 12. The impacting device of claim 1, furthercomprising a handle operably associated with the shaft, wherein thehandle has at least one flat side.
 13. The impacting device of claim 5,wherein the V-shape has a highest point substantially near a center ofthe second channel.
 14. The impacting device of claim 1, wherein thefirst and second channels do not intersect an upper surface opposite thebase surface.
 15. The impacting device of claim 1, wherein the basesurface is substantially continuous and includes no openings therein.16. The impacting device of claim 1, wherein the lateral surface and thebase surface both intersect the second longitudinal axis.